Provider Demographics
NPI:1659988194
Name:JIMENEZ, LIZANA (RN)
Entity Type:Individual
Prefix:
First Name:LIZANA
Middle Name:
Last Name:JIMENEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 E 28TH ST
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-8333
Mailing Address - Country:US
Mailing Address - Phone:956-968-7833
Mailing Address - Fax:956-854-4090
Practice Address - Street 1:1900 E 28TH ST
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-8333
Practice Address - Country:US
Practice Address - Phone:956-968-7833
Practice Address - Fax:956-854-4090
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX723486163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health